PD40-02 ASSOCIATION BETWEEN ORAL ANTITHROMBOTIC DRUGS USE AND BLEEDING IN PARTIAL NEPHRECTOMY: A RETROSPECTIVE COHORT STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD40-02 ASSOCIATION BETWEEN ORAL ANTITHROMBOTIC DRUGS USE AND BLEEDING IN PARTIAL NEPHRECTOMY: A RETROSPECTIVE COHORT STUDY Yuzhe Tang, José Nolazco, Zhiyu (Jason) Qian, Marie-Thérèse Valovska, Kendrick Yim, Benjamin Chung, and Steven Chang Yuzhe TangYuzhe Tang More articles by this author , José NolazcoJosé Nolazco More articles by this author , Zhiyu (Jason) QianZhiyu (Jason) Qian More articles by this author , Marie-Thérèse ValovskaMarie-Thérèse Valovska More articles by this author , Kendrick YimKendrick Yim More articles by this author , Benjamin ChungBenjamin Chung More articles by this author , and Steven ChangSteven Chang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003345.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Whether perioperative period oral antiplatelet (AP) and anticoagulant (AC) drugs use can lead to bleeding in PN is controversial. This study analyzes the association between oral AP/AC use and bleeding complications in partial nephrectomy in a large cohort. METHODS: Using the Premier Hospital Database, we performed a retrospective cohort study of patients undergoing partial nephrectomy to manage kidney cancer and renal masses from 2003 to 2020. The study cohort was limited to adult patients undergoing elective surgery. Using administrative codes and billing, we assessed for an association between AP/AC drug use and bleeding complication using mixed-effects multiple logistic regression models controlling for a wide range of clinical-demographic, surgical, and hospital factors. The primary outcome was bleeding within 90 days in or after surgery. Secondary outcomes were mortality rate 90 days after surgery and length of hospital stay. RESULTS: The study cohort comprised 48,112 partial nephrectomy patients, of which 10.9% had bleeding complications. Mixed-effects multivariable logistic regression models revealed that AP was associated with 31% increased odds for bleeding (OR 1.31; 95% CI: 1.15-1.49; p<0.01) and AC was associated with 2.25 times odds for bleeding compared with none users (OR 2.25; 95% CI: 1.85-2.74; p<0.01), AP and AC combination group was associated with the most bleeding risk (OR 3.09; 95% CI: 2.q4-4.74; p<0.01). An effect modification of oral AP drug use and Myocardial infarction (MI) history was detected, which is shown in Figure 1. The relationship between surgeon volume and bleeding risk was presented as a "J" shape (Figure 2). More than 33 cases/year for PN surgeons entered a plateau phase and slightly increased the bleeding risk. CONCLUSIONS: AC/AP use is associated with a significant increase in bleeding complications following partial nephrectomy surgery; Compared with AP, AC induces more probability of bleeding; AP and AC combination lead to even more bleeding risk. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1051 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yuzhe Tang More articles by this author José Nolazco More articles by this author Zhiyu (Jason) Qian More articles by this author Marie-Thérèse Valovska More articles by this author Kendrick Yim More articles by this author Benjamin Chung More articles by this author Steven Chang More articles by this author Expand All Advertisement PDF downloadLoading ...